自体血贮存在不同温度时红细胞形态的变化

Altered morphology in erythrocytes of autologous blood stored at different temperatures

背景:输血指南指出:全血应在(4±2)℃贮存,血液一旦离开正确的贮存条件,即有发生细菌繁殖或丧失功能的危险,受血者输注后则会发生不同程度的输血反应或输注无效。目地:利用显微镜观察自体血贮存在不同温度下红细胞形态的变化。方法:40例急性等容血液稀释患者取血后贮存在ACD枸橼酸血袋,分别贮存在4℃和常温23℃,于放自体血后即刻、自体血贮存1,2,3,4,5,6 h分别取样涂片,利用显微镜观察红细胞形态变化,计算红细胞畸形率。随机选取6 h段常温组血样与有效期内的ACD库存血各6份进行pH、K+、游离血红蛋白等对比及细菌培养。结果与结论:4℃组和常温组在各时间点红细胞畸形率差异无显著性意义,6 h段常温组血样pH、K+、游离血红蛋白等均优于有效期内的ACD库存血,培养均无细菌生长。提示常温下自体血贮存6 h内回输给患者是可行的。

BACKGROUND： Transfusion guidelines pointed out： whole blood should be stored at （4±2）℃. The bacterial growth or loss of function should occur if the blood leaves the suitable storage conditions. Recipients will suffer from different degrees of blood transfusion reaction or invalid infusion. OBJECTIVE： To observe morphology of erythrocytes of autologous blood stored at different temperatures using microscope. METHODS： Blood was obtained from 40 cases of acute normovolemic hemodilution and stored in ACD citrate bags. Whole blood was respectively stored at 4 ℃ and 23 ℃. Blood smear was taken respectively in the blood storage immediately, 1, 2, 3, 4, 5 and 6 hours after collecting autologous blood. Changes in morphology of erythrocytes were observed with a microscope. Deformity rate of erythrocytes was calculated. Six blood samples were randomly selected to test pH, K＋, and free hemoglobin respectively in 6-hour common temperature group and ACD banked blood within the valid period. Six blood samples were randomly selected for the bacterial culture in each group of two groups at 6 hours. RESULTS AND CONCLUSION： There were no significant differences in abnormality rates of erythrocytes between 4 ℃ and common temperature groups at each time point. The pH, K＋, free hemoglobin at six hours in the common temperature group were better than those of ACD banked blood within the valid period and there was no bacterial growth in culture between the two groups. Therefore, it is feasible to transfuse autologous blood back to the patient within 6 hours of storage at room temperature.